Most healthcare consumers are keenly aware that healthcare costs have risen dramatically over the past decade. As the cost the healthcare itself has gone up, so has the cost of health insurance and healthcare benefit plans. Indeed, over the past decade, a twenty percent or greater increase in health insurance premiums in a single year has been commonplace. All indications are that this trend will continue. As a result, many employers and/or organizations have had to pass on to their employees/members a progressively greater share of the financial burden of healthcare benefit plans.
To help alleviate some of this financial burden, or at least give the employees/members more control over their expenditures, many employers and/or organizations now offer multiple healthcare benefit plans, often administered by multiple healthcare benefit plan providers. For example, an employer may offer employees a choice of one or more medical insurance plans, dental insurance plans, and vision services plans, any of which may be considered a health insurance plan and/or a healthcare benefit plan. In another example, a healthcare consumer may have the opportunity to purchase medical insurance through an industry organization, fraternal organization, labor union, alumni organization, or any other organization to which he or she belongs.
Each of these health care benefit plans has different plan characteristics. These plan characteristics include, but are not limited to: the conditions, services, treatments, and medications covered by the plans; the individual healthcare providers, provider groups, and healthcare facilities participating in the plans; the premiums paid by the employer/organization and/or the employees/members for employees/members and their eligible dependents; the specific deductibles, co-payments, out-of-pocket yearly maximum expenses, lifetime maximum expenses, and other financial characteristics; and the portability of the healthcare benefit plan and/or health insurance plan, i.e., is the plan only available while the consumer is an employee/member. In addition, different types of health insurance plans may be offered as, or as part of, a healthcare benefit plan, such as plans managed by a Health Maintenance Organization (HMOs), plans managed by a Preferred Provider Organization (PPOs), or High Deductible Health Plans (HDHPs).
In addition, in order to help employees further offset increased healthcare costs, many employers now offer healthcare expense account programs that are typically used in addition to, and often in conjunction with, traditional health insurance. Herein, healthcare expense account programs are defined as programs which provide an employee/healthcare consumer and/or employee's/healthcare consumer's dependents a designated healthcare expense account that is assigned to the employee/healthcare consumer and is used to reimburse the employee/healthcare consumer for defined eligible healthcare expenses incurred by the employee/healthcare consumer and/or the employee's/healthcare consumer's dependents. Typically, healthcare expense account programs are tax-advantaged accounts whereby the employee/healthcare consumer can use pre-tax funds to pay eligible healthcare expenses incurred by the employee/healthcare consumer and/or the employee's/healthcare consumer's dependents. Examples of currently available healthcare expense account programs include, but are not limited to: flexible spending accounts (FSAs); healthcare reimbursement arrangements (HRAs); and healthcare spending accounts (HSAs).
In addition, due, in part, to the increased cost of employer/organization sponsored programs and/or the desire to obtain a healthcare benefit plan that is not dependent on an employer, employment status, and/or an organization, many healthcare consumers desire information about self-sponsored healthcare benefit plans and want to consider, and/or enroll in, these programs as an alternative and/or supplement to any employer/organization sponsored programs.
As a result of the situation described above, healthcare consumers must often make multiple healthcare benefit plan decisions, including, but not limited to, which healthcare benefit plan to enroll in. However, in order to make an intelligent decision, the healthcare consumer is faced with a seemly overwhelming amount of data regarding the plan characteristics discussed above.
Given the number of variables and considerations associated with choosing a healthcare benefit plan, it is not surprising that many healthcare consumers feel overwhelmed by the process. As a result, many healthcare consumers do not feel they have the time or energy to gather and analyze all the relevant characteristic data for each plan. Consequently, these healthcare consumers often make this very important, and potentially life changing, decision in a somewhat uninformed and ad-hoc manner. On the other hand, those that do wade through all the data and various plan characteristics are often significantly inconvenienced by the process and, in some cases, are left feeling even more confused as a result of their considerable effort.
Currently, some methods and processes for helping healthcare consumer's choose a healthcare plan are available. However, these methods and processes typically provide highly generalized benchmark data and/or, at best, analysis based almost entirely on historical usage data. Consequently, these currently available methods and processes for helping a healthcare consumer choose a healthcare plan do not take into account predictable future health conditions in any meaningful and/or personalized way.